Home / Health / Colorado's 'Birthday Rule' Sparks Insurance Nightmare
Colorado's 'Birthday Rule' Sparks Insurance Nightmare
13 Jun
Summary
- A little-known Colorado rule dictated insurance coverage for a newborn.
- The 'birthday rule' automatically assigned primary coverage based on parent's birth month.
- The situation caused months of confusion and nearly $400,000 in disputed medical bills.
A Colorado family's experience highlights the confusion caused by the state's 'birthday rule,' which determines newborn health insurance coverage. For Megan and Jonathan Perr, this little-known regulation automatically made Jonathan's Anthem plan primary for their premature son, Benjamin, whose birth date is later in the year than his father's.
Following Benjamin's birth in August 2025 and subsequent weeks in the NICU, the family believed his medical bills were covered under Megan's UnitedHealthcare plan. However, months later, insurance payments were reversed, leading to threats of hundreds of thousands of dollars in disputed charges.
Anthem initially denied the claim, citing a lack of medical records. The Perr family spent months making over 100 phone calls to resolve the issue, experiencing significant stress and time away from caring for their infant. The Colorado Division of Insurance is now reviewing the regulation, considering whether parents should have a choice in plan selection within the first 30 days of a newborn's life.
Anthem has stated they received the necessary medical records and plan to resolve the issue. The family hopes sharing their story will prevent other parents from facing similar challenges with unexpected insurance rules.
